Diabetic ketoacidosis due to fulminant type 1 diabetes: A rare subtype of type 1 diabetes leading to unusual sequelae. (February 2015)

• Record Type: Journal Article
• Authors: Lane, Andrew S; Champion, Bernard; Orde, Sam; Dravec, Danijela
• Is Part Of: Journal of the Intensive Care Society. Volume 16:Number 1(2015:Feb.)
• Page Start: 64
• Page End: 70
• Publication Date: 2015-02
• Subjects: Fulminant type 1 diabetes -- pneumomediastinum -- stress induced cardiomyopathy -- troponin -- Takotsubo cardiomyopathy; Critical care medicine -- Periodicals; Intensive care units -- Periodicals; 616.028
• DOI: 10.1177/1751143714551249
• Languages: English
• ISSNs: 1751-1437

Abstract

Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D), which without treatment leads to death. Fulminant type 1 diabetes (FT1D) is a subtype characterised by a markedly rapid and almost complete destruction of pancreatic β-cells, with acute onset leading to severe metabolic derangement and commonly ICU admission. We present a case of an 18-year-old male presenting with FT1D with two rare complications of pneumomediastinum and stress-induced cardiomyopathy (SIC) with significant myocardial necrosis. We also discuss the aetiology of the pneumomediastinum; the latest thoughts on SIC: moving beyond the simple description of 'Takotsubo cardiomyopathy'; the role of troponins in critical illness; and genetic predisposition for DKA due to FT1D.